Canadian government discourses on the overdose death crisis: limitations of a bio-evidenced approach

Abstract

Purpose Critical analyses of health policies and practices may appear to lack practicality during unprecedented times that demand immediate solutions. This paper aims to use critical social science theories to help improve essential service delivery during a public health crisis. Design/methodology/approach This study is based on qualitative content analysis of government and scholarly sources between 2008 and 2021 to identify strengths and gaps underlying the Canadian Federal Government’s evidence-based solutions to the opioid death crisis. Key questions examined are: What constitutes best-evidence practices underlying the Canadian Drugs and Substances Strategy?, Is biomedical evidence the only legitimate framework to substantiate feasible interventions? and Because the opioid death crisis affects disproportionately vulnerable populations, what is the potential merit of considering diverse knowledges and practices as valid forms of intervention despite lacking biomedical evidence bases? Findings While overdose reversing drugs, drug replacement approaches, biologically focused harm reduction options and pharmacological regulatory and surveillance initiatives help reduce premature opioid-related morbidity and mortality across provinces, this study’s findings demonstrate that these individualizing, biomedical magic bullets are temporary solutions, not comprehensive plans to solve a societal problem. This study’s theoretically informed analysis shows that the Canadian Federal Government responses detract attention from issues of social justice, social inequities and the biomedical dominance of health care as broader forces of the opioid death crisis. To address these analytical omissions, broader evidence-based solutions must build upon meaningful intraventions, the insiders’ perspectives or voices of the afflicted communities alongside meaningful interventions – going beyond distal, clinical-based and proximal, home-based interventions. Originality/value By highlighting the biomedical and social embeddings of the opioid death crisis, this study underscores structural conditions rather than individuals’ physical bodies as the catalysts for change. A deeper theoretical understanding of why certain issues exists, as they do and how they occur, can provide the basis for prediction of their (re)occurrence and for informing meaningful intervention efforts.